A broken heel bone is a serious injury usually caused by a hard fall or car accident. It causes severe pain, swelling, and difficulty walking, and may require surgery to heal properly.
A calcaneus fracture is a break in your heel bone, which is the largest bone in your foot. Your heel bone bears much of your body weight when you stand and walk, so injuries to this bone can significantly affect your ability to move around. These fractures are usually caused by high-energy trauma such as falling from a height or being in a motor vehicle collision. Older adults or people with weak bones (osteoporosis) can sometimes break their heel bone from lower-impact injuries.
Heelbone fractures range from simple cracks that don't involve the joint surface to complex breaks that damage the joint where the heel meets the bones above it. Complex fractures can lead to long-term pain, stiffness, and arthritis if not treated properly.
If you have a heel bone fracture, you will typically experience sudden, severe pain in your heel immediately after the injury. You may also notice:
In some cases, if tendons are also injured, your Achilles tendon (the thick cord at the back of your ankle) may appear pulled up, and you may lose some strength when pointing your foot downward.
Most heel bone fractures occur from falls from height or car accidents, where the impact forces your heel bone to compress and break. In these high-energy injuries, the bone above your heel (the talus) acts like a wedge, crushing the heel bone beneath it.
Other types of heel bone breaks can occur from twisting injuries or from forces pulling on the Achilles tendon, especially in people with weak bones. Older adults and people with osteoporosis are at higher risk for heel fractures from even minor falls.
Your doctor will start by examining your foot and asking about how the injury happened. The first step in imaging is usually X-rays of your ankle and foot. However, normal X-ray measurements do not completely rule out a fracture.
For a definitive diagnosis, especially if the fracture is complex, your doctor will order a CT scan (computed tomography). CT provides detailed images that help determine the exact pattern of the break and guide treatment decisions. If your doctor suspects a stress fracture (a small crack from repeated stress rather than trauma), an MRI (magnetic resonance imaging) may be used.
Your doctor may also look for bruising on the sole of your foot, which is a common sign of heel bone fracture.
Initial treatment focuses on managing pain, controlling swelling, and protecting your foot from further injury. Your doctor may give you pain medication, apply ice and elevation, and fit you with a bulky splint or cast. You will need to avoid putting weight on your injured foot.
**Nonoperative (nonsurgical) treatment** may be an option if your fracture is not displaced (the pieces are still aligned), if it's a stress fracture, or if you are not a good candidate for surgery. This approach involves wearing a cast or boot for several weeks or months while your bone heals. You will gradually return to bearing weight as the fracture heals, guided by your doctor.
**Surgical treatment** is usually recommended if your fracture is significantly displaced, involves the joint surface, is an open fracture (bone breaks through the skin), or causes deformity. Surgery aims to realign the bone pieces, restore the joint surface, and stabilize the fracture using screws, plates, or other fixation devices. Your surgeon may use a minimally invasive approach with percutaneous fixation (metal pins placed through small openings in the skin) or open surgery to directly visualize and repair the fracture.
Recovery from a heel bone fracture is a gradual process that can take many months. If treated nonoperatively, you will wear a cast or boot and avoid weight bearing for 6 to 12 weeks, depending on how the fracture heals.
If you have surgery, initial recovery involves keeping your incision clean and dry, managing pain, and keeping your foot elevated to reduce swelling. You will remain non-weight-bearing for a period of time, and your doctor will monitor your healing with X-rays.
Once your doctor clears you to gradually put weight on your foot, physical therapy becomes important to restore strength, flexibility, and normal walking patterns. Even after your bone has healed, you may experience some ongoing heel pain or stiffness, and you may need to avoid high-impact activities like running or jumping.
Full recovery typically takes 3 to 6 months for simpler fractures and longer for complex breaks. Return to sports and heavy activities should be guided by your sports medicine doctor.
See a doctor immediately if you experience severe heel pain after a fall, car accident, or other injury. Seek emergency care right away if:
Early diagnosis and treatment provide the best chance for proper healing and the lowest risk of long-term complications like arthritis and chronic pain.
Connect with a doctor, physical therapist, or imaging center near you.
Find a Provider Near You →